Urology/DRE

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Question
Dr: When a Medical Professional does a DRE and they feel something how do they distinguish if it is a nodule(Like on the Prostate)a Hemorrhoid or Polyp? The Physician said he was certain it is Hemorrhoids, that the Prostate felt fine and is small.Thanks!

Answer
Mike, the prostate is a small distinct gland about the size of a walnut.  It is noted by palpation through the wall of the rectum.  It is approximately 1-2 inches inside the anus and is located beneath the anterior rectal wall (towards the navel).  It typically is smooth &  has a consistency like the tip of the nose.  The physician feels for general size, nodules, & areas of abnormal firmness.

A polyp is usually smooth, fleshy and moveable. They can be found anywhere inside the GI tact (from the esophagus to the anus).  As opposed to the prostate which is actually outside of the lining (mucosa) of the GI tract, polyps are inside.  They arise from the mucous membrane (lining) of the GI tract and are attached by a narrow stalk.  Most are benign but they can be malignant.

Hemorrhoids are swollen varicose veins of the lower rectum or anus.  They may be inside the anus ("internal") or outside the anus ("external").  They may or may not be painful and sometimes bleed.  They may clot producing a "thrombosed" hemorrhoid.  Thrombosed hemorrhoids are usually firm and tender to touch.  External hemorrhoids are obvious as they can be seen.  Internal hemorrhoids can be palpated as smooth, round, soft lesions.  

The distinction of these 3 lesions is generally quite easy for most physicians.  I hope you now understand the differentiation.   Good luck.

Urology

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Arthur Goldstein, M.D.

Expertise

Problems or questions related to the field of urology; ie urinary stone disease, urinary cancers (kidney, bladder, prostate, testis, etc.), urinary infections, etc. I no longer answer questions related to erection problems or male sexual dysfunction.

Experience

I am retired from the active practice of urology. My 34 years was totally in the clinical field and involved the entire gamut of genitourinary problems, with special interest in endourology.

Organizations
American Medical Association, American Urological Association, American College of Surgeons

Education/Credentials
College degree - BS Medical degree - MD Master of Science - MS

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